Next •Previous
What is dialysis?
Dialysis is a treatment for patients whose kidneys do not function well or no longer function at all. The patients go to a dialysis facility three times a week to receive treatments with a dialysis machine that pulls the patients blood through an artificial kidney called a dialyzer. The treatments cleanse the patients blood of the by products that the body accumulates normally during digestion and are normally excreted through the kidneys in the form of urine.
Treatment is initiated in several different ways. Some patients have had surgery to have an access placed in their arms the access is a vein and an artery which have been sewn together to form one very large vein. The connection of the two veins is called a Fistula. If a patients veins are not adequate a graft, which is a plastic tube, may be placed in the arm or thigh. There are patients that have an access in the form of tubes inserted into a major vein leading to the heart. The tubes have caps on the ends.
Patients with kidney failure have only had access to dialysis treatments for a short period of time. In the history of dialysis the first dialysis patient was recorded as having a dialysis treatment in 1960 in Seattle. Medicare only opened up the possibility for poor people to receive dialysis in the 70’s. Before that time only a few people had assess to dialysis as an option for the treatment of their kidney failure. From the history of dialysis On October 30, 1972 the national ESRD program—Public Law 92-601—was passed as an amendment to the Medicare Act after only 30 minutes of debate with only one dissenting vote. The senate followed with a 52-3 vote. Senator Vance Hartke (D-Ind.) summed up the rationale for the new law:
In what must be the most tragic irony of the 20th century, people are dying because they cannot get access to proper medical care. We have learned how to treat or to cure some of the diseases (that) have plagued mankind for centuries, yet those treatments are not available because of their cost. Mr. President, we can begin to get our priorities straight by undertaking a national effort to bring kidney disease treatment within the reach of all those in need.The bill, signed into law by President Nixon, gave all Americans the right to treatment for ESRD, regardless of age. ESRD was and remains the only medical condition given this status. The law exceeded expectations and posed challenges due, in part, to its costs. At the time of its passage, the government expected to care for some 16,000 patients, a patient load reached by 1974. By 1999 there were one quarter of a million patients. Similarly, the annual budget was projected at $250 million but, by 2000, it was more than $15 billion. There are now 4,200 dialysis clinics around the country. Medicare covers 83 percent as primary or secondary payor.